School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Phys Ther. 2023 Nov 4;103(11). doi: 10.1093/ptj/pzad109.
The self-administered version of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is used to monitor function and disease progression in individuals with amyotrophic lateral sclerosis (ALS). However, the performance of the self-administered ALSFRS-R has not been assessed using Rasch Measurement Theory. Therefore, the purpose of this study was to examine the psychometric properties of the self-administered ALSFRS-R using Rasch analysis.
Rasch analysis was performed on self-administered ALSFRS-R data from individuals with ALS across Canada. The following 6 aspects of Rasch analysis were examined using RUMM2030: fit via residuals and chi-square statistics, targeting via person-item threshold maps, dependency via item residual correlations, unidimensionality through principal components analysis of residuals, reliability via person separation index, and stability through differential item functioning analyses for sex, age, and language.
Analysis was performed on 122 participants (mean age: 52.9 years; 62.8% men). The overall scale demonstrated good fit, reliability, and stability; however, multidimensionality was found. To address this issue, items were divided into 3 subscales (bulbar, motor, and respiratory function), and Rasch analysis was performed for each subscale. The subscales demonstrated good fit, reliability, stability, and unidimensionality. However, there were still issues with item dependency for all subscale and targeting for bulbar and respiratory subscales.
The self-administered ALSFRS-R is reliable, internally valid, and stable across sex, age, and language subgroups; however, it is recommended that the ALSFRS-R be scored by subscale. Future studies can look at revising and/or adding items to tackle misfit, redundancy, and ceiling effects.
Self-administered measures are simple to administer and inexpensive. The self-administered ALSFRS-R was found to be psychometrically sound and can be used as a tool to monitor disease progression and function in ALS.
肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）的自评版本用于监测肌萎缩侧索硬化症（ALS）患者的功能和疾病进展。然而，尚未使用 Rasch 测量理论评估自评 ALSFRS-R 的性能。因此，本研究的目的是使用 Rasch 分析检查自评 ALSFRS-R 的心理测量特性。
使用来自加拿大各地 ALS 患者的自评 ALSFRS-R 数据进行 Rasch 分析。使用 RUMM2030 检查了 Rasch 分析的以下 6 个方面：通过残差和卡方统计的拟合，通过人员项目阈值图的目标，通过项目残差相关性的依赖性，通过残差主成分分析的单维性，通过人员分离指数的可靠性，以及通过性别、年龄和语言的差异项目功能分析的稳定性。
对 122 名参与者（平均年龄：52.9 岁；62.8%为男性）进行了分析。总体量表表现出良好的拟合、可靠性和稳定性；然而，发现了多维性。为了解决这个问题，将项目分为 3 个子量表（延髓、运动和呼吸功能），并对子量表进行了 Rasch 分析。子量表表现出良好的拟合、可靠性、稳定性和单维性。然而，所有子量表仍然存在项目依赖性问题，延髓和呼吸子量表的目标也存在问题。
自评 ALSFRS-R 可靠、内部有效且在性别、年龄和语言亚组中稳定；然而，建议按子量表评分。未来的研究可以考虑修改和/或添加项目以解决不拟合、冗余和上限效应。
自评量表易于管理且成本低廉。自评 ALSFRS-R 被证明具有良好的心理测量特性，可作为监测 ALS 疾病进展和功能的工具。
